B. In lower third of leg.--This is an easier and more scientific operation, as it does not involve the division of great tendons. An incision midway between the internal malleolus and the tendo Achillis, parallel with both, will expose the very deep and strong fascia in which the tendons lie. The artery, with its venæ comites, occupies a central position, having the tendons of the tibialis posticus and flexor communis in front between it and the internal malleolus, and the posterior tibial nerve behind it, while the flexor longus pollicis lies still nearer the tendo Achillis. TABLE illustrating anastomotic circulation after ligature of arteries of lower limb. 1. AORTA.--Epigastric and mammary of both sides. Hæmorrhoidal and spermatic, with branches of pudic both deep and superficial. 2. COMMON ILIAC.--Internal iliac and branches, with those of the other side, along with the following:-- 3. EXTERNAL ILIAC.--Internal mammary and deep epigastric. Iliolumbar and lumbar branches of aorta, with deep circumflex ilii. Pudic from internal iliac, with superficial pudic of common femoral. Gluteal, sciatic, and obturator, with the circumflex and perforating branches or deep femoral. 4. FEMORAL.--External circumflex, with external articular of popliteal. Perforating, with branches of gluteal and sciatic. Profunda branches with anastomotica and articular branches. Obturator and internal circumflex with anastomotica and superior internal articular. NOTE.--The importance of the articular branches of the popliteal explain the danger of gangrene after a sudden rupture or increase in size of a popliteal aneurism. LIGATURE OF THE INNOMINATE.--The performance of this extremely dangerous, in fact almost hopeless operation, is by no means so difficult as might be expected. The patient lying down with the shoulders raised and head thrown well back, the sternal attachment of the right sterno-mastoid must be very freely exposed. This may be done by an incision (Plate I. fig. 7) along its anterior edge from the upper edge of the sternum, as far as may be necessary; another about the same length along the upper edge of the clavicle, will meet the former at an acute angle, and will include a triangular flap of skin, which must be carefully dissected up. The sternal, and probably a portion of the clavicular attachment of the right sterno-mastoid, must then be cautiously divided. This being done, the sterno-hyoid and sterno-thyroid muscles require division immediately above their sternal attachments.